i still saw people i lost. and this one guy, he was, he just kept talking to me and he, um, he says, "you got ptsd and you got it bad." he says, "there's someone you need to talk to." i'm glad that you doing that. i think that would be nice for you to have. my son jason had, you know, after 911, felt like he needed to go serve his country, went over. he came back from there. he started gambling or, started to use recreational drugs, and, thank goodness, i got arianna day's name and her program was just phenomenal. you would call the 800 number that we have listed and you'll reach a live person. i'm thinking that maybe housing voucher, you know, applying for that is going be probably a good option for you. and then they are going to direct your call to our program.

and really listen to what the needs are, the challenges are with that veteran or family. i've had difficulties in the fact that i have nightmares. and so, in that situation of having those nightmares and having those flashbacks, um, it was very difficult for, for the reunion. family members are, you know, are really impacted because they really sacrifice a lot while their spouse is in theater. you know, they are taking on a number of different roles, and so when their spouse returns, it is, it can be even more challenging. they come back and they're, they're in this heightened state of awareness. and their, you know, their adrenaline is rushing and now they're supposed to come back and just flow into everyday life. in situations where we need to expedite something for a veteran to get va healthcare services, we're able to really get those needs met timely.

in the case of the veterans' program, we do a lot of transportation to mental health appointments. and we'll try and get the vet to the place that they need to be while arianna is arranging for either intake at a specialized treatment center or some temporary. if programs like this were not available, everybody, families would be struggling on their own, not knowing what resources were out there. my father served in the military and it was his career, and so for me the military has always been a second family. in working with this program, it was just a great opportunity for me to show my appreciation for the life that i was given as a child of the military. they're not here to coddle you. but, they're here to let you know we can help you, get you to resources wherein we can help you move forward. so, mike, you wanted to add a little bit after

kathryn noted, um, the issues with the suicide, ah, concerns. just to put some context into the conversation, so everyone understands, so veterans represent approximately 6 percent of the u.s. population. but they represent 20 percent of all the suicides in this country. so, you know, clearly the discussion that we're having is, is very important, um, the, and i think as we talk about community and the extent to which we can address some of these ideas around isolation with the support of the community, i think, it, there's also another challenge here that the community didn't go to war, you know, 1 percent of the country went to war and the peer research group released a study just a couple of months ago where they actually surveyed americans. and, um, asked them questions about the extent to which this past decade of war has impacted their lives in any meaningful way. and the majority of americans responded, really, a decade of war hasn't impacted me at all.

and further, upwards to 80 percent of americans said that they really don't understand the issues and challenges facing the community of veterans. so, i think as we talk about addressing issues like suicide and the extent to which we need to educate the family, um, it's critical that we also broaden that focus with regard to educating all of america with regard to the issues facing this community. so, that there really can be that broad-based community support. i think there is this issue relative to the discussion of suicide, that i had mentioned, that is important. and i think it is the difficulty, the discrimination, and the myths about the way you have to engage to talk about suicide is one thing we have to overcome. and that's particularly true in the military because of the warrior culture. and the military itself is shifting their own philosophy and values and saying it's acceptable to talk now about

the fact that you might be considering suicide. you have to understand that that may be going on in the military. and the great thing about the fact that, that military members become depressed, also think about suicide, which is a normative experience in many ways, that what is available is 1-800-273-talk, which is the national suicide prevention lifeline and when anyone calls that number, if they are a veteran or want to be connected with a veteran, they hit the #1 and they are immediately connected to condigo, new york, and the host of trained counselors on the phone. so, we are able to get people connected immediately and walk them through the crisis. and i think having those kinds of resources available and that the community knows about is one way to combat the issue. and barbara, you were noting before, during the break, that essentially it's not just about the service man or woman-it really goes beyond that it extends into the family in terms of the, the threats that suicide poses?

well, our families have been under stress for, at 10 years of war and plus and what research has been showing is that our families are having increased need and request for mental health services. also, seeing an increase in alcohol and drug abuse, um, especially when the service member is deployed. and so as, um, our study found that depending on how well the communication was going on between the nondeployed spouse and the children dictated as far as how well the household did but also how well the children did. and if the nondeployed spouse was experiencing any sort of mental health issues that in itself increased issues within the children. they have not been tracking as far as what's happening as far as with our families. are our suicide rates up as far as with our spouses and with our children? are our attempts up with those particular population as well?

we appreciate the fact that there is a lot of focus on our service members, our guard and reserve, and our veterans, but, also, to our families have been under a tremendous amount of stress; they, too, are experiencing issues. there is still stigma that exists as far as with them. they're afraid as far as to come forward to mention that they themselves are having issues because what's the impact now on the service member, the guardsmen, the reservists. so they are reluctant as far as to come forward and we hear stories constantly as far as when they do come forward, sometime situations happen that they did not necessarily want to have happen. so, there is an issue as far as looking to see how the mental health of our providers are doing. you know, they have also been forward deployed, seeing all the injuries in battlefield. then they come back and are deployed, i mean now they are assigned to our military treatment facilities. at walter reed, bethesda, or um, down at bamc as far as brook and how are they doing, are they having,

have they had opportunities to reintegrate with their families, have they had the right amount of dwell-time? and now they are back taking care of the same service members or guardsmen and reservists that they took care of in theater and they are still having all of the stresses as far as with their job and not necessarily had time to come down as far as being in theater. and that's who our families are going to. i mean, we're more likely, research has shown, in the civilian sector in this research that just came out with the, um, what'd you call it, medical surveillance monthly report showing basically that provider, i mean, you have gone in to see a provider, a healthcare provider, you know, within the first 30 or 60 days before you've either attempted or, or um, actually completed suicide. so, as we are looking at that particular piece, we need to make sure that our providers are healthy, so that when we do come in to see them that they are assessing us for how we are doing for our mental health. jen, i want to go back to give an hour. talk a little about that program and what it tries to do.

sure, give an hour is a national nonprofit and we provide free mental health care to post 911 veterans, their families, and the communities. so, it's anybody who's been impacted by the current conflicts overseas. what happens is that they can come to our website and they search our provider data base and they can find somebody who's willing to donate therapy to them. so, i mean, we have psychiatrists, psychologists, social workers, r.n.s, l.p.n.s, we have a whole entire gamut of people who are willing to donate their services to try to help out our military families and communities. well, that is very honorable. um, kathryn, along with that, the president has made the services to military families a priority. talk to us a little bit about what samhsa is specifically doing under the strategic initiative. part of the president's initiative included pulling together the 16 cabinet secretaries to create a report called strengthening military families. and samhsa represented hhs the department of health and

human resources in that group. and our samhsa initiative is really derivative of that report and that report's focus. and in that report, there was a, um a, goal, the first goal was to strengthen the psychological health of military service members, veterans, and their families. and so the department of health and human services, as a partner, basically, with the va and with the department of defense pledges to do whatever it can to support the psychological health of this population. so, samhsa has taken on the military service members, veterans, and their families as an initiative to focus specifically on the behavioral health issues for this population. and to insure that any individual who needs it has access to appropriate behavioral health services. and those services are what are considered to be evidenced-based practices that are focused on recovery. that includes the center for trauma?

that is correct. and we have, we have a variety of resources with-in samhsa, we have a trauma initiative, we have, um, the center for trauma-informed care, we have, um, a focus on a, making sure that what we call recovery-oriented services are available through our community providers and through the states. so, samhsa is not, um, getting in the way either va or dod doing their appropriate mission. but we are partners with them in the sense that both state authorities and behavioral health and community service agencies are understanding this population. and so, our role is to, is to certainly educate our partners in cultural competence of what it means to be in the military and get those individuals like folks that jen works with in terms of the professionals understanding what it means to be, ah, in the military and the military culture and the military environment and seeing themselves as partners,

so that if an individual chose not to use either va services or other services, we would make sure they were aware of those services, but that our community providers would also be available to provide behavioral health-particularly focused on substance abuse disorders, addictions, and mental illnesses. and that happens quite often, you find a lot of military and veteran personnel who don't want to go to the federal agencies. they don't want to go to the va because we're afraid of that, the stigma. stigma that barbara was talking about? absolutely, the stigma, we're warriors, we're soldiers, we're supposed to be able to handle everything. that's the mentality, that, you know, we have instilled in us. but not only that, but it's the confidentiality thing as well. we don't get that when it goes on our permanent record. so, by being able to go to these outside community resources where everything is confidential, it will never get back to my military community or my veteran community, i feel safer in going and talking to them, so some vets and military personnel choose to do that. and i think that is what i find very novel about that,

that program. and when we come back, we will be continuing our chat about the resources available to help our military men and women. we will be right back. [music] before, addiction and depression kept me from living my life. and now, every step i take in recovery benefits everyone. there are many options that make the road to recovery more accessible. it begins with the first step. join the voices for recovery. for information and treatment referral for you or someone you love, call 1-800-662-help. brought to you by the u.s. department of health and human services. [music]

dav's mission is simply to build better lives for disabled veterans and their families. we are known for helping veterans with their claims for veterans' benefits. what do you need assistance with today? i'm looking to check on my claim for my ptsd. about 2 in 10 have ptsd, a little bit more for major depression. and it goes up from there. in fact, bipolar is roughly 3 in 10.

your iu claim is a new claim and it's been issued 2 weeks ago? we first look for the physical disabilities. and many times, a physical disability is the cause of a mental disability. all i had to do was sit home and, you know, try and recuperate and i, and i went into a depression. once we can get them treatment for the mental disorder, then we can control their substance abuse. and that is what we look for when we tell them to seek treatment at a va facility. since all of dav's natioanl service officers are disabled veterans, we have a connection with the veteran who sits across the table with us. and we are able to get them to relax a little bit more and give us a little bit more information about their mental health conditions and the symptoms that they have with it and how they are treating those symptoms. when a veteran comes in and they have got this barrier up about their mental health, they don't want to get treatment, they don't want that stigma. i always look at 'em and i ask 'em, "if you had a broken leg,

and the bone is sticking out of your, out of the skin, would you sit here and say, 'oh, it will be all right, everything is going to get better,' or would you go to the hospital and get treatment?" families are the backbone of the military. you know, a lot of veterans who come home who have mental health conditions don't realize it. the spouses and the children are the first to realize that they're a changed person. a spouse can come to us and say, "my husband has these symptoms what should i do?" are you currently getting treatment? yes. if a veteran doesn't seek proper mental health treatment for their mental health or substance abuse, worst case scenario is death. we start using to escape things that you don't want to think about it. and all of a sudden, you're right back here and you got nothing but time to think. and the last thing that you wanna do is think about it. they can go to the va-it's free and it's unlimited. i've seen veterans who came back, they had everything going for 'em, but they didn't get treatments.

and the next time i saw them, they were living in their sister's basement, no job, no money, no wife. take your early effective date and iu claim and we'll see where you, we can go from that. so, what we do is try to identify what type of mental disorder they have. once we get them identified, then we send them to the necessary places, va medical centers to get a diagnosis, and then we help them with their claim to establish benefits for mental disorders. counselor out there said that it's not actually a light at the end of the tunnel, it's a candle in the middle of the tunnel and you've got to go get this, pick up that little light and keep going, 'cause that's not the end. barbara, i heard you, um, wanted to make a comment at the end of the last panel. i did. so, samhsa is, ah, doing a wonderful job through their state policy academics as far as educating providers along with military one source about military culture.

and so, our association has been asking for, let's make sure that we have, either a, um, a ceu that's out there for providers to go and take on our military culture. and actually, the department of defense has created one. but also, making sure that a curriculum gets built with in all the schools a that, um, offer courses for behavioral health providers or even for our family practice doctors. so, they understand what military culture is and so that's within their practice from then on. but samhsa has a wonderful state policy academy not only as far as educating about the military being out there, but the states themselves getting together talking about ways in which they can make things better for the military. of the state policy academies, we have had 3, and 23 states have been through them already. and so, each of those states now has a strategic plan on how they are going to address the behavioral health needs of their returning veteran and military service member population. and, and we find that the state leadership then gets connected with their adjacent general, they get connected with a, um,

give an hour, they get connected with the yellow ribbon, they get connected with all of this sort of state resources that are in that particular state. and then it gets to be a much more collaborative approach and you hopefully have a much more focused attention. and so, we're looking forward to doing another policy academy in september for another 10 states. so, we're really excited. mike, i want to go back to you, um, we've been talking about, utopia in, in terms of what is working. talk to us about where the systems still need to be improved. you know you kicked off the, you kicked off this, this panel by asking the question why is this important? you know, and i think that's another question that, we intuitively come to the conclusion that's, it's important because we need, we have a debt to repay to the-and all of that stuff is absolutely true. but, you know, this is, we are, we are only a couple of decades into an experiment with an all voluntary

military in this country. and, you know, i truly believe that if we fail this generation of veterans, that experiment with an all voluntary military will fail as well. and we talk about being out in the community and we talk about understanding and all of these, for me, i guess, as somebody who, um, spends the majority of my time running programs for veterans. working with this generation of veterans, i am not convinced that sometimes i wonder if we're, if we're preaching to the choir. you know, the people who are showing up at these meetings and conferences are, are the ones who already understand, because i'm not convinced that, there is as broad understanding among citizens as to, um, the, to the, the issues and challenges impacting this community. and, i think until we get there, um, we're,

it will be an uphill battle. and kathryn, that also argues for more coordination of services which you were specifically addressing so that, the state, the local municipality, the national programs, begin to really understand what resources are available and we can maximize- that's correct and i think that one of the things that we've found, um, is that for too long there were closed systems. dod had a closed system, the va had a closed system, and then there was the rest of the healthcare system in the world. and what we're, what we're absolutely discovering is that they cannot do it alone, they should not do it alone, those closed systems have to open their doors and windows, they have to have partnerships in the community. they, we cannot have replicated systems in silos, no more. and i think that we have to encourage leadership, frankly, in dod and va and we have to encourage leadership

across the federal government, leadership in the states, leadership at the local level to make sure that those kinds of collaborations and the level of coordination that is necessary to help be more directive about what's available is the most important thing we can do. i think that we, we have to encourage the civilian community to, to understand more, to understand better, um. but that's really done by a factor of using the bully pulpit of not only president but also the secretary of health. absolutely. and even the secretary of defense coming forward and saying, "you know, i, i, you know, speaking to particularly nontraditional, nonmilitary groups about what's going on. that's an excellent idea. as an example, to illustrate this point, you can look at vets in higher education today. so, um, this generation of veterans has accessed the post-911 gi bill, which is the most generous educational benefit that has been afforded to this community since the, um,

gi bill after world war ii. um, but at the same time, we're seeing exceptionally high dropout rates of veterans in higher education, um, depending on which study or who you listen to, it's anywhere between 50 and 70 percent are are starting school and then dropping out. why do you think that is happening? well, we actually, we did a study and we actually reached out and surveyed large numbers of student veterans and we ask them questions about what do you perceive as the impediment to your educational success? and in, at the top of the list was i don't feel like i fit in on this college campus. i don't feel like my student peers understand my unique situation. i don't feel like faculty and administrators understand my unique situation. and that's, that's the kind of understanding, i think, you need, we need to get to in order to really move the needle. and, and deal with some of these issues.

barbara, im going to you, and ask you if you had a magic wand, i ask you prior to starting the show, what do you think would be the priority in terms of what needs to change and improve or what do we need to continue to do in order to provide better services? we need to make sure that we are continuing to build resilience in our military families, so that they can handle whatever comes their way. i always use the terminology, focus up stream. in other words, let's care for them while they are still on active duty, um, give them the tools that they need in order to be able to survive not only as far as access to good family support programs but also make sure that they have access to education and an, a portable job, so that no, no matter what comes their way, so if there is an injury or an illness the family is able to, is to handle all that. what keeps me up at night though it what is the long-term impact of this war? we have no idea, i mean the high percentage of our veterans with

traumatic brain injury that have been experienced through their time in, in theater. what other long-term impact for that as far as the high percentage of post-traumatic stress, you know, what's the impact on that as well? but what about our children? i mean, who's going to care for them when their adults and they're not in the military? it's going to be the communities who are going to be out there as far as for us. what about the parents or what about the spouses now that are divorced? so it's the entire family... right. very, very good point. so it's really looking at reintegration and making sure that our communities are also aware of, of the support and are also providing um, support for us. jen. i personally think that it is all about community collaborations. i, we talked about, you know, the schools and how the students don't feel like they fit in there and, well, if we have svo and the student veterans organizations available, if we have an educated faculty as well as educated students, you are going to have these people who are going to be able to continue their education and do the things that they

need to do with their lives. and find the support. absolutely. and, you know, that is a big, big missing piece right now. kathryn. i think as we continue to strengthen our families and we are out in the, the civilian communities more and more, that is a big part of this educative process. i also think that, that, that this is a promise, we've made a promise to this generation and we need to do everything we can. i wanna see more employers, ah, willing to open up their employee ranks to veterans. and to make whatever kinds of, employment arrangements are necessary in order to use the skills of this very skilled workforce. and think broadly about how to bring them back into work. if people work, and they feel a sense of belonging, um, i think that's our promise to them and we have to do that and it's the civilian community that has to do that, it's not the military community. mike. for me, it's about education, i think at the end of the day. um, in the, in the scope of issues that, that we're dealing with in the context of this community.

i think education is, is well positioned to advance the postservice life course of this nation's veterans, there's a there's a window of opportunity with the current, um, post-911 gi bill. but, we haven't done a great job implementing that, and i'm talking about both government and institutions of higher education. you know, right now, for example, um, 8 of the top 10 recipients is institutions of gi bill money last year, were um, on line for profit universities that have a dropout rate of higher than 65 percent. and they are not held accountable. we need to hold them accountable. very good. i want to remind our audience that september is national recovery month we want to encourage you to go online at www.recoverymonth.gov and find all of the wonderful materials, so everyone can get engaged. and during september, also support military families and vets in their struggle to come back, be reintegrated into

society, and get the necessary help that they need and they deserve. it's been a great show, thank you very much. thank you. for a copy of this program or other programs in the road to recovery series, call samhsa at 1-800-662-help or order online at recoverymonth.gov and click multimedia. [music] every september, national recovery month provides an opportunity for communities like yours to raise awareness of substance use and mental health problems; to highlight the effectiveness of treatment and that people can and do recover. in order to help you plan events and activities in commemoration of this year's recovery month observance, the free online recovery month kit offers ideas, materials, and tools for planning, organizing, and realizing an event or

outreach campaign that matches your goals and resources. to obtain an electronic copy of this year's recovery month kit and gain access to other free publications and materials related to recovery issues, visit the recovery month website at www.recoverymonth.gov or call 1-800-662-help. [music]